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Flies in the Operating Room

Nothing feels more alien than moving to a new town, let alone a new country. But an emergency trip to a Brazilian trauma center shows author Amy Ragsdale and her family that hospitals are places where people connect universally.

Nothing feels more alien than moving to a new town, let alone a new country. But an emergency trip to a Brazilian trauma center shows author Amy Ragsdale and her family that hospitals are places where people connect universally.

Still jet-lagged, I was wakened from my nap by someone pounding on the door of our third-floor room in an old colonial mansion. The person's weight shifted restlessly on the foot-wide floorboards.

“Yes? Oi?” I couldn’t pick apart the rat’s nest of Portuguese coming through the door, but I instantly understood that it was urgent and something about my son.

Our family of four had arrived three days earlier in Penedo, in northeastern Brazil, where brightly colored nineteenth-century row houses, sunny plazas, and flame trees line an expansive stretch of the Rio Sao Francisco. We would be living here, in the Pousada Colonial, for a year as part of our on-going effort to raise global children. We had lived five years earlier in the capital city of Mozambique, but as a result of that experience, this time our kids requested that we live in a small town. They wanted total cultural immersion—no foreigners, no English.

I swung the door open to find Breno, our 12-year-old-son Skyler's newfound friend. Fumbling into my flip-flops, I hurried after him as he lumbered down the wood stairs.

Our first night in town, Skyler, and his 15-year-old sister, Molly, had managed to join a game of soccer. They played barefoot on paving stones. That night Skyler made two friends, Breno and Vito. But now Breno was here and Skyler was nowhere to be seen.

As we spilled out the door of our B&B into a blast of sunshine, I saw the long crumbling balustrade across the plaza, bordering the wide river, then Vito, standing by a small, unmarked car. Skyler’s orange Crocs dangled from one hand. Flip-flops slapping cobblestone, we panted up to him. Vito’s eyes looked worried. I peered into the car. There was Skyler, sitting in front. His blonde hair was dark with blood.

“I was flipping,” he choked out shakily, “off a stone wall.”

Vito and I scrambled into the backseat as the car started up a steep hill. I had no idea where we were going. I had said nothing to the driver, nor he to me.

I find when traveling in new places, in a different language, I frequently trust people I might not as readily at home, as though, subconsciously, I recognize I'm not in position to be in control. As a result, I find it easier to let go of my normal inclination to question and assess.

I reached forward, putting a hand on Skyler’s shoulder.

“It won’t stop bleeding.” His voice began to crack.

We’d noticed that, new to town, knowing no one, and bereft of language, Skyler was pulling out every trick he knew with his newfound friends: juggling oranges, solving Rubik’s Cubes, flipping off the stone walls that surround the plaza into the sand of the riverbank below.

“I did two back flips"—he took a big breath—“no problem. Then I decided”—his voice began to sound squeezed—“to try a side flip.”

The car skidded under the carport of the tiny hospital’s Emergencia. Luckily, early on a Sunday it wasn’t busy. Skyler was whisked onto a gurney, surrounded by what seemed to be the entire staff of ten. They rolled him through the open entrance of a low concrete building, into a simple room. Standing at his feet, I watched as a nurse began squeezing water out of a plastic bottle into his wound, cleaning out sand and blood. A deep gash began to emerge, arcing from the crown of his head down to his left ear.

Perhaps I looked more aghast than I realized, because I was suddenly ushered out into the hall, where I was asked to “fica um pouco.” “Wait a little.” I sat down in one of the few white plastic chairs scattered along the empty hallway, too dazed to think. I felt as though the little boat cradling our family of four had suddenly been sucked off a calm sea into a whirlpool.

Before long, an older doctor in a long white coat pushed open the door of Skyler’s room and walked over to me.

“É profundo,” he said softly. I didn’t need a dictionary to understand that. “Sério. Go get your husband,” he gently suggested in Portuguese.

They would bandage Skyler’s head and prepare him for the ambulance trip to the trauma center in Arapiraca, an hour away. He needed a neurosurgeon and a CAT scan.

I hustled out the front door to go find my husband, Peter, and Molly. Vito was still waiting outside. Piling into a taxi, we sped back to the Pousada Colonial, tires vibrating over cobblestones, and were halfway back when I realized I hadn’t even told Skyler I was leaving. I was stricken, imagining him unable to understand what anyone was saying, wondering why they were loading him into an ambulance, and then, why he was all alone.

Back at the pousada, I found both Peter and Molly were out. Peter had gone for a run, and Molly was passeando around town with new friends. I threw passports and clothes into a bag and, most importantly, scrambled to find the English-Portuguese dictionary. This idea of living abroad every few years wasn’t going quite as planned. My parents had done that with me, but it had never turned out like this! Peter returned just as I was leaving—someone in the plaza had intercepted him to tell him something had happened to his son. We agreed that he and Molly would follow in a taxi after Vito had found her.

By ambulance the hour-long trip took 30 minutes, even over the bucking, shoulderless, two-lane road. I sat in the windowless back of the little van with Skyler stretched on a gurney in front of me, and Cassia, the nurse from Penedo, poised over his head. I would later realize we'd passed ambling villages with plaster houses rimmed in cool verandas, surrounded by the eye-popping green of rolling sugarcane fields. But at the time, I barely looked up from Skyler’s face. Initially, he was talking a lot, frustrated with himself for getting hurt, peeved that he was missing the World Cup soccer finals, which we had planned to watch that afternoon. Portuguese was the first reason we’d decided to spend a year in Brazil. Soccer was the second, at least for Peter and Skyler.

But now Skyler’s eyes were beginning to close and his speech to drift. Cassia had been deftly changing his blood-soaked head bandage as we jounced through the potholes. She shook her head as he drifted toward sleep, looking worried.

“Skyler, let’s do some math problems!” I said urgently. He’d always been good at calculating numbers in his head. “What’s, uh, what’s 36 times, times 412? No, would two digits be better? How about 36 times 52?”

He seemed to think. “One thousand... eight hundred…and seventy-two?”

“Great. That’s great,” I said, having no idea what the answer was myself. I just wanted to keep him talking, awake, alive.

We were dipping into a gully when the pavement turned to dirt, and we were suddenly caught in a twisting knot of cars slowly picking their way through water-filled ruts. Are we going to put on the siren, flash some lights? But we just slowed down, patiently waiting our turn.

Within minutes the ambulance slid into the carport at the trauma center, another nondescript white concrete building. The back door was ripped open. Skyler was slid out and whisked through an opening without a door, past rows of chairs with a few waiting people, and through a heavy, metal floor-to-ceiling accordion gate. It clanged shut. He was in. I was out? The gate was manned by men in khaki, their pants tucked into leather boots, machine guns slung casually over their shoulders. One put his arm out and softly motioned me to the side. I watched as Skyler was rolled away.

The receptionist was asking me something.

“Skyler Stark-Ragsdale?” I hazarded, hopefully.

He smiled and tried again. I finally managed to give my name and relationship, Skyler’s name, age, and nationality, and a mimed description of a side flip, of his accident. They let me through.

An armed guard led me to a small white room down the hall. An intensely bright light was being trained on Skyler’s head. As always in Brazil there was a crowd, most in scrubs, some in masks, some focused on Skyler, others just chatting with their neighbor. Two flies buzzed through the circle of light.

By the time Peter and Molly got there, 45 minutes later, Skyler had been given seven Novocaine shots and a Frankenstinian stripe of nineteen stitches arcing from the top back of his head down to his left ear. His CAT scan had checked out normal, and I’d been able to give him the running score on the World Cup finals, which, of course, the CAT scan technicians had been watching.

But it wasn’t over. They wanted to keep Skyler for observation. As the evening wore on, Skyler and I were transferred from room to room, as space was needed. We watched as the gate clanged open and an increasing number of cases, each more gruesome than the last, were wheeled through. We shared rooms with men who appeared to have been shot, knifed, and beaten. We listened to them wheezing into respirators, watched blood clotting their bandages. Privacy was not an option.

We met a lot of people at the trauma center, which serves the surrounding 52 towns. They came to help, to interpret, or just to check in on the Americanos. Cassia, the ambulance nurse from Penedo, who’d hugged me when my eyes teared on hearing Skyler’s CAT scan was normal, stayed with us for the next four hours when she could have gone home.

I’ve always dreaded the possibility of ending up in one of these hospitals, with their mildewed walls, gaping entrances, and flies in the operating room. I now know, however, that they can be full of smart, competent, and kind people. And they're sanitary enough.

Released too late to go back to Penedo, we spent the night in a small hotel and delivered flowers to the trauma center staff the next day before returning home. Thanks to the Brazilian health care system, the entire event, ambulance and all, was free.

When we got back to Penedo everyone seemed to know what we’d been through.

“Seu filho?” “Your son?” strangers stopped to ask.

I knew they were wondering who we were; how, like aliens, we had landed in their town. But no one addressed that now. This was more important. I was a mother with a son, and he had been hurt.

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